Effects of vitamin D with calcium and associations of mean 25-hydroxyvitamin D levels with 3-year change in muscle performance in healthy older adults in the Boston STOP IT trial

Authors: DAWSON-HUGHES, BESS - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; WANG, JIFAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; BARGER, KATHRYN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; CEGLIA, LISA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Calcified Tissues International
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/7/2022
Publication Date: 9/26/2022
Citation: Dawson-Hughes, B., Wang, J., Barger, K., Ceglia, L. 2022. Effects of vitamin D with calcium and associations of mean 25-hydroxyvitamin D levels with 3-year change in muscle performance in healthy older adults in the Boston STOP IT trial. Calcified Tissues International. https://doi.org/10.1007/s00223-022-01024-5.
DOI: https://doi.org/10.1007/s00223-022-01024-5

Interpretive Summary: Vitamin D supplementation appears to reduce risk of falling in vitamin D deficient and insufficient older adults, but recent evidence indicates that supplementation in this population does not improve muscle strength or performance. The mechanism by which supplementation lowers fall risk is unclear. We assessed the impact of 700 IU of vitamin D3 and calcium vs. placebo on muscle strength, performance and balance over 3 years in 388 healthy older adults. Supplementation had no effect on muscle strength or performance; however, a higher blood level of 25-hydroxyvitamin D during the study was associated with improved balance on one of two balance tests. This suggests that correcting low blood levels of 25-hydroxyvitamin D may improve balance in older adults, but this finding needs to be confirmed.

Technical Abstract: The purpose of this analysis was to assess whether 1) daily vitamin D3 plus calcium supplementation vs. placebo or 2) the mean 25-hydroxyvitamin D [25(OH)D] level achieved during a 3-year trial was associated with muscle performance or balance in the Boston STOP IT study. Methods: We conducted exploratory analyses in 388 men and women age 65 years and older who participated in the Boston STOP IT trial and had one or more muscle performance or balance assessments at baseline and 3 years. Participants were treated with 700 IU of vitamin D3 plus 500 mg of calcium or with double placebo daily for 3 years. Plasma 25(OH)D was measured at baseline, 6, 12, 18, 24, and 36 months; muscle performance (timed walk, grip strength, and chair-rise) and two balance tests, the one-leg stand and tandem stand, were assessed at baseline and 3 years only. Results: Supplementation with vitamin D3 and calcium had no significant effect on any muscle performance measure. The 3-year mean 25(OH)D levels were 22.7 +/- 6.3 (SD) in the placebo and 30.8 +/- 7.5 ng/ml in the supplemented groups (p<0.001). The 3-year mean 25(OH)D level was positively associated with change in one-leg stand time (p = 0.04), but not with the other measures. Conclusion: Vitamin D3 and calcium supplementation had no significant effect on muscle performance or balance in this relatively healthy older population. A higher 3-year mean 25(OH)D level may favor balance, as indicated by longer one-leg stand time, but this observation should be confirmed.